Aliskiren as effective at lowering BP as ARBs

Source: MedWire News

Findings from a 10-study meta-analysis suggest that the direct renin inhibitor aliskiren is as effective as angiotensin receptor blockers (ARBs) at treating hypertension.

The results, published in the American Journal of Hypertension, also indicate that the risk for adverse events, namely headache, nasopharyngitis, diarrhea, and back pain, does not differ with aliskiren and ARB treatment.

This, say the authors, suggests that "aliskiren might provide the same tolerability as ARBs in controlling blood pressure (BP)."

Dengfeng Gao (Xi'an Jiaotong University School of Medicine, Shaanxi, People's Republic of China) and team analyzed 10 studies involving 3732 patients with hypertension, defined as a BP level of at least 140/90 mmHg.

The studies compared aliskiren 150-300 mg (n=2149) with losartan 50-100 mg (two studies), valsartan 160-320 mg (three studies), or irbesartan 150-320 mg (five studies; n=1583 for all ARBs) taken for 4 to 12 weeks.

The researchers found that by the end of the treatment period, mean BP reductions did not differ significantly between the aliskiren and ARB treatment groups.

Specifically, in the studies that compared aliskiren with losartan, BP fell by a mean of 11.1/7.3 versus 11.0/9.7 mmHg, while in the aliskiren versus valsartan studies, BP fell by a mean of 13.4/10.4 versus 14.9/11.0 mmHg. Results from the studies that compared aliskiren with irbesartan revealed mean BP reductions of 12.0/8.1 versus 9.9/6.8 mmHg.

Gao and colleagues also highlight: "Aliskiren treatment did not differ from the three ARBs in number or proportion of adverse events... or withdrawal due to adverse events."

Indeed, adverse events occurred in 36% of patients taking aliskiren versus 37% of those taking an ARB. And withdrawal due to adverse events or death occurred in 2.3% and 2.7% of patients taking aliskiren and ARBs, respectively.

"Some comparative data from this study may be helpful for clinical practice," say Gao and team.

They conclude that their findings suggest a need for further investigation into "how well aliskiren works in patients with inadequate response to ARBs, because aliskiren might be a replacement for ARBs."